Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.12318
Revista de Odontologia da UNESP
Original Article

Biomechanical development and evaluation of a new framework for all-on-four rehabilitation

Desenvolvimento e avaliação biomecânica de uma nova infraestrutura para reabilitações “all-on-four”

Vanessa Araujo SILVA; Allyson Henrique de Andrade FONSECA; Dimitri Ribas FONSECA; Paulo Isaías SERAIDARIAN

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Abstract

Abstract: Introduction: For complete rehabilitation of fully edentulous mandibles, the option for immediate loading determines the use of temporary prostheses that splint the installed implants. Although temporary prostheses with reinforcement provide rehabilitations with biomechanical benefits, the non-adoption of this recommendation coexists in different studies on immediate restorations.

Objective: This study evaluates a type of prosthesis to restore jaws by the all-on-four concept.

Material and method:: The mechanical behavior of prostheses with the modified framework was evaluated in vitro, under a cantilever mechanical unilateral bending test. Two representative groups were included in the all-on-four concept, with a G1 test group (n = 10) containing modified frameworks and a G2 control group (n = 10) that included full acrylic prostheses. The samples were submitted to thermal cycling with 500 cycles (5° ± 2 °C for 30 s, and 55° ± 2° for 30 s) and to the mechanical bending test on the cantilever.

Result: The Mann-Whitney test revealed a significant difference between G1 and G2 (p <0.001). In the descriptive evaluation, G1 averaged 830.50 N until the initial resin fracture, while the control group presented a mean of 403.58N. The maximum resistance until complete fracture was recorded in G1, with a mean of 903.03N, while in G2, a mean of 435.20N was recorded. The linear vertical component of the flexion was 0.68 mm and 0.39 mm until the initial fracture of the bar, respectively for G1 and G2.

Conclusion: The modified framework for the all-on-four protocol determined better mechanical performance when compared to the same full acrylic prosthesis model.

Keywords

Immediate loading on dental implant, mandible, framework, dental implants

Resumo

Resumo: Introdução: Para reabilitação de mandíbulas totalmente edêntulas, a opção por carga imediata determina a utilização de próteses provisórias que esplintem os implantes instalados. Apesar de provisórias com reforço proverem as reabilitações com benefícios biomecânicos, a não adoção desta indicação coexiste em diferentes estudos sobre restaurações imediatas.

Objetivo: Este estudo avaliou um tipo de prótese para reabilitar mandíbulas pelo conceito “all-on-four”.

Material e método:: Foi avaliado, in-vitro, o comportamento mecânico de próteses com a infraestrutura modificada, sob ensaio mecânico de flexão unilateral em cantilever. Foram avaliados dois grupos representativos para o conceito “all-on-four”, sendo um grupo teste G1 (n = 10) contendo próteses com infraestrutura modificada e outro controle G2 (n = 10) que incluiu próteses totalmente acrílicas. As amostras foram submetidas à ciclagem térmica com 500 ciclos (5° ± 2 °C por 30 segundos e 55° ± 2 °C pelo mesmo tempo) e submetidas ao ensaio mecânico à flexão sobre o cantilever.

Resultado: O teste de Mann-Whitney revelou diferença significativa entre G1 e G2 (p<0,001). Na avaliação descritiva, G1 mostrou média de 830,50 N até a fratura inicial em resina e o grupo controle apresentou média de 403,58N. A resistência máxima até a fratura completa foi de 903,03 N para G1 e para G2 de 435,20 N. O componente vertical linear de flexão foi 0,68 mm e 0,39 mm até a fratura inicial da barra, respectivamente para G1 e G2.

Conclusão: A infraestrutura modificada para o protocolo “all-on-four” proporcionou melhor desempenho mecânico quando comparado ao mesmo modelo de prótese totalmente acrílico.
 

Palavras-chave

Carga imediata em implante dentário, mandíbula, infraestrutura, implantes dentários

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